Active NPI
Rachelle Quenneville, PHARM.D
- Pharmacist
- Southgate, MI
National Provider Identifier
1871099218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5301007259
- Practice address
- 15700 Northline Rd
Southgate, MI 48195-2378 - Phone
- (734) 285-0030
- NPI assigned
- Apr 4, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5301007259 | MI | Primary |
Addresses
Primary practice location
15700 Northline Rd
Southgate, MI 48195-2378
Mailing address
485 Kenwood Blvd
Lasalle, ONTARIO N9J2L8
CA
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5301007259 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522800000000",
"number": "1871099218",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "485 KENWOOD BLVD",
"city": "LASALLE",
"state": "ONTARIO",
"postal_code": "N9J2L8"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15700 NORTHLINE RD",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481952378",
"telephone_number": "734-285-0030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUENNEVILLE",
"first_name": "RACHELLE",
"name_prefix": "Dr.",
"credential": "PHARM.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-04",
"last_updated": "2018-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "MI",
"license": "5301007259",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southgate, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.